Employee Hearing Checks
*Hearing monitoring
Prolonged exposure to hazardous noise can have harmful effects on worker health. Monitor the hearing health status of the noise-exposed workers to identify changes then take action to prevent further damage.
How do we know if noise is affecting the hearing of our workers?
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An audiometric testing programme checks the hearing thresholds of workers and tracks them over time. The objective is to detect changes or shifts in hearing that may signal the beginning stages of noise-induced hearing loss (NIHL). Identifying the signs and symptoms early enough, allows employers to intervene before the symptoms get worse. Therefore, part of the audiometric testing program is to ensure that effective follow-up actions are taken.
Audiometric monitoring programmes depend on checking hearing thresholds in a consistent, standardized manner, using trained and competent personnel. The test room should be quiet enough to minimize distractions for valid thresholds to be obtained. A baseline hearing check (audiogram) done before the worker’s first exposure to hazardous noise is then compared to future, routine hearing checks. Typically done annually, these results help to identify problems, such as hearing threshold shifts.
Audiometric test programmes can be offered in a variety of ways, including in-house testing, mobile service providers, or at a health clinic. They may be performed by an audiologist or physician, but are most commonly done by audiometric technicians or occupational health nurses with specialty training. Any problem audiograms must be reviewed by an audiologist or physician to help determine follow-up actions. For example, in some cases, medical follow-ups are necessary. If permanent hearing loss occurs, a professional can help to determine whether it is related to noise on the job.
The audiometric results can be used on an individual basis to teach workers about their own hearing health status. Also, the whole audiometric database can be analysed to identify trends and develop appropriate intervention plans. The results of the hearing checks should trigger follow-up actions.
Key Takeaways
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- Routine hearing checks can help detect early symptoms of over-exposure to hazardous noise.
- Effective follow-up for workers with hearing shifts can help prevent permanent noise-induced hearing loss.
- Quality audiometric testing programmes rely on consistent procedures, standardized practices, and competent personnel.
- Careful review of hearing test results help determine what follow-up actions are needed and if workplace noise is a factor.
- The audiometric database is a snapshot of the hearing health of the noise-exposed workforce and can be used to identify trends and develop intervention plans.
Key Terms
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- Annual audiogram
- Audiogram
- Audiologist
- Baseline audiogram
- Baseline revision
- Bio-acoustic simulator
- Calibration
- Decibel
- Hearing Level
- Hearing Threshold
- Hertz
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- Maximum Permissible Ambient Noise Levels
- Noise-induced hearing loss
- Occupational Hearing Conservationist
- Permanent threshold shift
- Problem audiogram
- Professional Supervisor
- Retest audiogram
- Standard Threshold Shift (STS)
- Temporary threshold shift
Purposes of Audiometric Testing
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- Checking hearing, through an on-going monitoring programme, is the health surveillance part of the hearing loss prevention program (HLPP). When workers are exposed to hazardous noise, they should be checked routinely. The purpose of the hearing check is to identify small changes in hearing which may be a symptom of being over-exposed to noise. Workers who show no changes in hearing, despite working in hazardous noise, are assumed to be well-protected. However, those who show hearing threshold shifts, need an intervention plan.
- Hearing testing can also be done in order to assess suitability of a worker for a particular job, if that job has specific criteria for hearing. For example, in order to obtain an appropriate license, an airplane pilot or commercial driver must have good enough hearing to meet the requirements.
- Hearing evaluations can also be performed to determine the cause of the hearing loss for purposes of determining if a hearing loss is work-related.
Getting Started With Audiometric Testing
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Step 1. Identify who is required to have a hearing test
As stated in the Control of Noise at Work Regulations 2005, all workers whose exposure exceeds the Upper Exposure Action Values, must have the right to have his/her hearing checked by a medical physician or by another suitably qualified person under the responsibility of the medical physician. Preventative audiometric testing should also be available to workers whose exposure exceeds the Lower Exposure Action Values. Look for noise exposure information in the noise survey records/reports. Noise surveys typically help to identify which areas, jobs, and/or individuals, are at or above the action level.
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Step 2. Choose how to deliver the testing programme
Knowing how many workers will be tested annually will help to determine the best method for delivering the hearing tests. Many factors, such as quality, employee time away from the job, flexibility, space, personnel, access to records, and total cost of the program, are all typically considered. The goal is to establish a robust long-term programme that is stable and continuous. Keep in mind that the cost of poor quality can be high, not only in dollars, but also in wasted time and effort, worker health, productivity, and morale, and employer liability.
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Step 3. Schedule and conduct testing
Scheduling the tests is somewhat dependent on the method chosen for delivering them. For example, testing can be spread throughout the year or done within the same week or month every year. Some considerations for scheduling can include; the time or season of the year, the start and end times of the work shift, and the availability of workers to be away from job tasks. Employees who need a baseline test should avoid workplace noise exposure for 14 hours, or wear hearing protection prior to the test.
Conducting hearing checks also gives other opportunities to interact with workers. Extra training can be provided and the condition and fit of the hearing protection can be checked.
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Step 4. Send all problem audiograms to a physician or an audiologist for review
Once the tests are complete, there is usually follow-up work to be done. This means that workers who may have a significant change in hearing, signs of a hearing loss, or questionable test results, should have their records reviewed by a medical health professional to determine if and what additional intervention is needed.
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Step 5. Complete any follow-up actions needed.
There are many types of follow-up actions that may be necessary based on the audiometric test results and the medical history information given by the worker. Some types of follow-up are required and others are optional. It is typically helpful to work with a physician or audiologist to outline follow-up and intervention needs. Some examples of follow-up actions are: retesting and retraining workers who have experienced a standard threshold shift (STS), retesting a worker who had an incomplete or invalid test, referring workers with signs of medical conditions to a physician or audiologist, fit-testing of hearing protection, investigating workplace hazards, and determining work-related hearing loss.
The following is a brief outline of audiometric testing. Specific requirements may vary from one EU member country to another, always consult you national regulation for further advice.
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Who must have an audiometric test? Who can perform the test?
Who needs an audiometric test?
Typically, all employees who are exposed at or above the continuous noise Upper Exposure Action Value LEPd,8h = 85 dB(A) should be included in an audiometric monitoring program.
Who can perform audiometric tests?
Testing can be completed by a competent person such as an audiologist, occupational health nurse, or a medical physician.
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What are the key requirements of the testing programme?
- Audiometric testing must be available at no cost to employees
- Audiometers must meet specified equipment and calibration requirements
- Testing must be conducted in accordance with national regulation
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When are audiometric tests conducted?
Baseline tests
Typically, baseline measurements are made when a new employee is hired, when there is change in noise measurements or new equipment procurement. Check your national regulation for more detailed advice, including frequency of testing.
Retest
Typically, retests are carried out annually when a worker shows a change in hearing threshold when compared to the baseline. Refer to your national regulation for further advice.
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Where are the tests conducted?
Tests are carried out in an audiometric booth/room which meets specified criteria. Check with an audiologist, occupational health nurse and other competent authorities.
Have You Considered?
Answers to common questions
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What triggers mandatory hearing tests?
Employee daily or weekly noise exposures reaches 85 dB(A) for continuous noise
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When does the baseline audiogram have to be done?
When the worker noise exposure exceeds the Upper Exposure Action Value and preventative audiometric testing be made available for those who are exposed to noise levels above the Lower Exposure Action Value.
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How often are hearing tests done?
Typically once a year, but check with your national regulation for more information.
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Can the employee work in noise before the baseline test?
Yes, but only if hearing protection is worn during the noise exposure.
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Can the employee work in noise before the annual test?
Yes.
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Can the employee be sent to an external vendor for the hearing test?
Yes, as long as they are competent enough to carry out the measurements, interpret the data, and that there is no cost to the employee by doing so. It is the employer’s responsibility to appoint a suitable vendor.
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I have a worker with a hearing aid. Can a test be done?
Yes, however the hearing test must be done without the hearing aid. If necessary, the worker could be tested by an audiologist.
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I have a worker who has severe tinnitus. Can I still test hearing?
Yes, however sometimes tinnitus (ringing in the ears) can make it more difficult to obtain valid thresholds. If the results are inconsistent, the worker may be having trouble distinguishing the test tone from the ringing in his ears. One option is to refer the worker to an audiologist to obtain a valid test.
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My employees don’t speak English. How can they be tested?
One option is to use an interpreter to explain the purpose of the test and instructions. Some audiometers have an additional feature to instruct the worker through the earphones, in the preferred language.
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Is it required to look in the ears with an otoscope before the test?
A visual inspection of the ear canal can give helpful information about the health of the ear and whether or not a test should be conducted.
Resources for Audiometric Testing
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IMPORTANT NOTE: This information is based on selected current national requirements. Other country or local requirements may be different. Always consult User Instructions and follow national regulations. This website contains an overview of general information and should not be relied upon to make specific decisions. Reading this information does not certify proficiency in safety and health. Information is current as of the date of publication, and requirements can change in the future. This information should not be relied upon in isolation, as the content is often accompanied by additional and/or clarifying information. All applicable national laws and regulations must be followed.
Contact your local 3M office for further information.
